I thank Assistant Professor Tripathi and Dr Kumar for their reply. (1) I do prescribe the “anti-dementia” drugs, explaining to my patients that this is because they may produce mild symptomatic improvements in the short term. We may argue about definitions, but to me this is not “improving outcomes”.
After judicial review in 2010 it was confirmed that National Institute for Health and Care Excellence (NICE) “was not irrational in concluding that there is no cumulative benefit to patients after 6 months treatment with these drugs”. (2)
The Alzheimer’s Society has much more recently stated through its Dementia Ambassador Fiona Phillips that “current treatments only help with symptoms for a short while”. (3)
The point of my letter was to highlight the difference between what evidence shows and what the “prevailing view” can be and also how this can shift in a short period of time.
(1) Tripathi, S & Kumar, A. “Anti-dementia” drugs improve the outcome. 15 July 2014. http://www.bmj.com/content/348/bmj.g2607/rr/694590
(2) Outcome of judicial review for NICE guidance on drugs for Alzheimer’s disease. 24 June 2010. http://www.nice.org.uk/newsroom/features/outcomeofjr.jsp
(3) Alzheimer Society film: Dementia Ambassador, Fiona Phillips. 14 Jan 2014 http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1629